COMPARISON BETWEEN TIRZEPATIDE AND SEMAGLUTIDE IN OBESITY MANAGEMENT: CURRENT EVIDENCE ON WEIGHT REDUCTION, METABOLIC PROFILE, AND TOLERABILITY
DOI:
https://doi.org/10.56238/levv16n51-048Keywords:
Obesity, Tirzepatide, Semaglutide, GLP-1 Receptor Agonists, Weight Loss, PharmacotherapyAbstract
Obesity is a chronic, multifactorial condition associated with high cardiometabolic risk, reduced quality of life, and lower life expectancy. Among the most promising pharmacological options for its treatment are glucagon-like peptide-1 (GLP-1) receptor agonists, such as semaglutide, and tirzepatide, which combines activity on both GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) receptors. This study presents a comparative review of these two drugs, analyzing efficacy, safety, tolerability, and clinical applicability based on recent randomized clinical trials and meta-analyses. The findings indicate that tirzepatide tends to promote slightly greater weight loss than semaglutide, possibly due to its dual mechanism of action, while semaglutide remains relevant due to its well-established safety profile and broad clinical use. Both drugs show a positive impact on weight control and improvement in metabolic parameters, with gastrointestinal adverse events being the most frequent. Therapeutic choice should consider individual factors, availability, and cost, emphasizing the need to combine these pharmacological interventions with sustainable lifestyle modification strategies.
Downloads
References
ALKHEZI, O. S. et al. Comparative effectiveness of glucagon-like peptide-1 receptor agonists for the management of obesity in adults without diabetes: A network meta-analysis of randomized clinical trials. Obesity Reviews, v. 24, n. 3, 2023.
BALD, E.; RABER, H. Semaglutide (Wegovy) for the treatment of obesity. American Family Physician, v. 107, p. 90, 2023. PMID: 36689981.
CAPEHORN, M. S. et al. Efficacy and safety of once-weekly semaglutide 1.0 mg vs once-daily liraglutide 1.2 mg as add-on to 1–3 oral antidiabetic drugs in subjects with type 2 diabetes (SUSTAIN 10). Diabetes & Metabolism, v. 46, n. 2, p. 100–109, 2020.
FERNANDES NASCIMENTO, M. H. et al. Eficácia e segurança da semaglutida comparada à terapia padrão de mudanças no estilo de vida para tratamento do sobrepeso e obesidade em adultos: revisão rápida de evidências. Revista Científica da Escola Estadual de Saúde Pública de Goiás, v. 9, n. 9j2, p. 1-16, 2023.
GOMES, H. K. B.; TREVISAN, M. O uso do Ozempic (semaglutida) como medicamento off label no tratamento da obesidade e como auxiliar na perda de peso. Revista Artigos.com, v. 29, e7498, 2021.
GUO, X. et al. The antiobesity effect and safety of GLP-1 receptor agonist in overweight/obese patients without diabetes: a systematic review and meta-analysis. Hormone and Metabolic Research, v. 54, p. 458-471, 2022.
HU, E.-H. et al. A review and meta-analysis of the safety and efficacy of using glucagon-like peptide-1 receptor agonists. Medicina (Kaunas, Lithuania), v. 60, n. 3, p. 357, 2024.
JENSEN, A. B. et al. Efficacy of the glucagon-like peptide-1 receptor agonists liraglutide and semaglutide for the treatment of weight regain after bariatric surgery: a retrospective observational study. Obesity Surgery, v. 33, n. 4, p. 1017-1025, 2023.
KIM, N. et al. Cost-effectiveness analysis of semaglutide 2.4 mg for the treatment of adult patients with overweight and obesity in the United States. Journal of Managed Care & Specialty Pharmacy, v. 28, n. 7, p. 740-752, 2022.
KOSMALSKI, M. et al. Pharmacological support for the treatment of obesity—present and future. Healthcare (Basel, Switzerland), v. 11, n. 3, p. 433, 2023.
LIRAGLUTIDA é aprovada como tratamento auxiliar para o controle do peso em adultos. 2016. Disponível em: https://www.gov.br/anvisa/pt-br/assuntos/noticias-anvisa/2016/liraglutida-e-aprovada-como-tratamento-auxiliar-para-o-controle-do-peso-em-adultos. Acesso em: 12 ago. 2025.
MARTINS, R. B. M. et al. Características sociodemográficas associadas ao baixo peso e ao excesso de peso em adultos com 50 anos ou mais (ELSI-Brasil): diferenças entre sexos. Cadernos de Saúde Pública, v. 40, n. 1, 2024.
MENDES, K. D. S. et al. Revisão integrativa: método de pesquisa para a incorporação de evidências na saúde e na enfermagem. Texto & Contexto Enfermagem, v. 17, n. 4, p. 758-764, 2008.
MIGOWSKI, A. et al. Análise temporal da prevalência da obesidade e do sobrepeso no Brasil entre 2006 e 2023: evidências a partir dos dados do Vigitel. OnScience, v. 2, n. 1, e00104, 2024.
BRASIL. Ministério da Saúde. Vigitel Brasil 2019: vigilância de fatores de risco e proteção para doenças crônicas por inquérito telefônico: estimativas sobre frequência e distribuição sociodemográfica de fatores de risco e proteção para doenças crônicas nas capitais dos 26 estados e no Distrito Federal em 2019. Brasília: Ministério da Saúde, 2020.
NIMAN, S. et al. A review on the efficacy and safety of oral semaglutide. Drugs in R&D, v. 21, n. 2, p. 133-148, 2021.
OLIVEIRA, I. P. D. et al. Semaglutida no tratamento de obesidade e sobrepeso. Research, Society and Development, v. 12, n. 3, e29812340656, 2023.
PIRES WEBER, T. et al. Uso do medicamento semaglutida como aliado no tratamento da obesidade. RECIMA21 - Revista Científica Multidisciplinar, v. 4, n. 2, e422731, 2023.
RUBINO, D. M. et al. Effect of weekly subcutaneous semaglutide vs daily liraglutide on body weight in adults with overweight or obesity without diabetes: The STEP 8 randomized clinical trial. JAMA: The Journal of the American Medical Association, v. 327, n. 2, p. 138, 2022.
SEIJAS-AMIGO, J. et al. Semaglutide versus GLP-1 agonists. Effectiveness, safety, and quality of life in patients with diabetes mellitus 2. The SEVERAL study. Farmacia Hospitalaria, v. 46, n. 6, p. 372-379, 2022.
SOUZA, A. da S. et al. A eficácia dos medicamentos semaglutida e liraglutida no tratamento da obesidade: uma revisão integrativa da literatura. Contribuciones a las Ciencias Sociales, v. 16, n. 11, p. 24819-24828, 2023.
STRETTON, B. et al. Weight loss with subcutaneous semaglutide versus other glucagon-like peptide 1 receptor agonists in type 2 diabetes: a systematic review. Internal Medicine Journal, v. 53, n. 8, p. 1311-1320, 2023.
TAN, H. C. et al. Efficacy and safety of semaglutide for weight loss in obesity without diabetes: a systematic review and meta-analysis. Journal of the ASEAN Federation of Endocrine Societies, v. 37, n. 2, p. 65-72, 2022.
TSAPAS, A. et al. Comparative efficacy of glucose‐lowering medications on body weight and blood pressure in patients with type 2 diabetes: a systematic review and network meta‐analysis. Diabetes, Obesity & Metabolism, v. 23, n. 9, p. 2116-2124, 2021.
VERMA, S. et al. Effects of glucagon‐like peptide‐1 receptor agonists liraglutide and semaglutide on cardiovascular and renal outcomes across body mass index categories in type 2 diabetes: Results of the LEADER and SUSTAIN 6 trials. Diabetes, Obesity & Metabolism, v. 22, n. 12, p. 2487-2492, 2020.
WEGOVY (semaglutida): ampliação de uso. 2024. Disponível em: https://www.gov.br/anvisa/pt-br/assuntos/medicamentos/novos-medicamentos-e-indicacoes/wegovy-semaglutida-ampliacao-de-uso. Acesso em: 12 ago. 2025.
XIA, L. et al. Comparative efficacy and safety of 8 GLP-1RAs in patients with type 2 diabetes: A network meta-analysis. Diabetes Research and Clinical Practice, v. 177, 108904, 2021.
